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Below are recommended vaccines and screening lab tests for refugees who have recently arrived in the US. Most refugees are required to these tests are part of the official US refugee program.

What do providers need to know when they see a patient in their clinic for a refugee health screening?
Our public health division has taken multiple steps to make this process easier for providers:1. The provider will usually get an inbasket message at the time the appointment is scheduled alerting them that they have an upcoming refugee health screening. This inbasket message will spell out specifically what vaccines and lab tests the patient needs. Many providers cut and paste this list into a note or the problem list in advance, or simply order the tests and vaccines at that time, to be administered when the patient arrives for the appointment.2. The lists of required labs and vaccines for refugees will be scanned into the patient's chart under the media tab. This list is now also on iSite and the ccrmc wiki (ccrmc.wikispaces.com, search "refugee").3. Most of these patients are healthy. Focus on obtaining the required vaccines and labs and a brief health assessment. If all the required labs and vaccines are not done you likely will get a message from public health asking you to order what's missing. If needed the patient can be brought back for further assessments.4. One common omission is ordering a CBC instead of a CBC w/diff. The differential is needed to check for eosinophilia, a marker for parasitic disease. Another is ordering a chronic hep panel but not a Hep B SAb as well. The Hep B Sab is not part of the chronic hep panel but is required. See the attached lists.Maggie Nguyen in the public health division is a resource to contact if you have further questions

REFUGEE HEALTH ASSESSMENT PROGRAM (RHAP)
REQUIRED LABORATORY TESTS
TESTS
FEFUGEES
QuantiFeron TB test
All Refugees
Complete Blood Count (CBC) and evaluation of eosinophilia
All Refugees
Complete Hepatitis panel, including:
Hepatitis B surface Antigen (HBsAg)
Hepatitis B surface antibody (anti-HBs) and Hepatitis B core antibody (anti-HBc)
And Hepatitis C Antibody Screen (anti-HCV)
All Refugees
HIV Antibody
All Refugees
Syphilis Screening RPR (if RPR reactive, perform TPPA/FTA-ABS/TP-MHA)
All Refugees ≥ 15yrs
Stool O+P (2 samples)
All Refugees
Random Serum Glucose
All Refugees
Random Lipid Panel
Men ≥ 35yrs, Women ≥ 45 yrs, or if Diabetes, Obese, history of Cardiovascular Disease, Hypertension or familial risk factors
Antistrongyloides Antibody Serology
All Refugees
Chlamydia Screen
Women >15 - ≤ 25 years or if risk factors are present
Lead
All Refugees 6 mos old to ≤ 16 years
Pregnancy test
Sexually active, 13-55 years
Fecal Occult Blood
≥ 50 years – 75







Table:Requirementsforroutinevaccinationofadjustmentofstatusapplicantswho are not fullyvaccinatedor lack documentation.
Vaccine
Age
Birth-1
Month
2-11
Months
12
Months-6
Years
7-10
Years
11-17
Years
18-64
Years
65
Years
DTP/DTaP/DT
NO
YES
NO
Td/Tdap
NO
YES, if 7yearsandolder(forTd); if 10yearsthrough64years(for Tdap-seeACIPschedule);if 65 yearsandolder(forTd)
IPV
NO
YES
NO
MMR
NO
YES, if bornin1957orlater
NO,if born before
1957
Rotavirus
NO
YES, if 6 weeksto
8 months
NO
Hib
NO
YES, if 2months through59 months
NO
HepatitisA
NO
YES, if 12 months through23 months
NO
HepatitisB
YES,birththrough18years
NO
Meningococcal
(MCV4)
NO
YES, if 11 years through18 years
NO
Varicella
NO
YES
Pneumococcal
NO
YES, if 2months through59months (forPCV)
NO
YES (for PPV)
Influenza
NO
YES,6months andolder(annuallyeachfluseason)















DTP=diphtheriaandtetanustoxoidsandpertussisvaccine; DTaP=diphtheriaandtetanustoxoidsandacellular pertussis vaccine;DT=pediatricformulationdiphtheriaandtetanustoxoids; Td=adultformulationtetanusand diphtheriatoxoids;Tdap=adolescentand adult formulationtetanusanddiphtheriatoxoidsandacellularpertussis vaccine(Boostrixforpersons10-64yearsold;Adacelforpersons11-64yearsold); IPV=inactivatedpoliovirusvaccine (killed);MMR=combinedmeasles,mumps, andrubellavaccine;Hib=Haemophilusinfluenzaetypeb conjugate vaccine;MCV=meningococcalconjugate vaccine;PCV=pneumococcalconjugate vaccine;PPV=pneumococcal polysaccharidevaccine.AdaptedfromACIPrecommendations.






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California Refugee Health Program Policyand Procedure Manual September2013